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Nosocomial infections, commonly referred to as healthcare-associated infections, are illnesses that patients get while hospitalized and are typically either not yet manifest or may develop. One of the most prevalent nosocomial diseases in hospitalized patients is pneumonia, among the leading causes of mortality and morbidity. Viral, bacterial, and fungal pathogens cause pneumonia. More severe introductions commonly included Staphylococcus aureus, which is at the top of bacterial infections, per World Health Organization reports. The staphylococci, S. aureus, strain RMI-014804, mesophile, on-sporulating, and non-motile bacterium, was isolated from the sputum of a pulmonary patient in Pakistan. Many characteristics of S. aureus strain RMI-014804 have been revealed in this paper, with complete genome sequence and annotation. Our findings indicate that the genome is a single circular 2.82 Mbp long genome with 1,962 protein-coding genes, 15 rRNA, 49 tRNA, 62 pseudogenes, and a GC content of 28.76%. As a result of this genome sequencing analysis, researchers will fully understand the genetic and molecular basis of the virulence of the S. aureus bacteria, which could help prevent the spread of nosocomial infections like pneumonia. Genome analysis of this strain was necessary to identify the specific genes and molecular mechanisms that contribute to its pathogenicity, antibiotic resistance, and genetic diversity, allowing for a more in-depth investigation of its pathogenesis to develop new treatments and preventive measures against infections caused by this bacterium.
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Background & objectives: Robust forecasting of malaria cases is desirable as we are approaching towards malaria elimination in India. Methods enabling robust forecasting and timely case detection in unstable transmission areas are the need of the hour. Methods: Forecasting efficacy of the eight most prominent statistical models that are based on three statistical methods: Generalized linear model (Model A and Model B), Smoothing method (Model C), and SARIMA (Model D to model H) were compared using last twelve years (2008–19) monthly malaria data of two districts (Kheda and Anand) of Gujarat state of India. Results: The SARIMA Model F was found the most appropriate when forecasted for 2017 and 2018 using modelbuilding data sets 1 and 2, respectively, for both the districts: Kheda and Anand. Model H followed by model C were the two models found appropriate in terms of point estimates for 2019. Still, we regretted these two because confidence intervals from these models are wider that they do not have any forecasting utility. Model F is the third one in terms of point prediction but gives a relatively better confidence interval. Therefore, model F was considered the most appropriate for the year 2019 for both districts. Interpretation & conclusion: Model F was found relatively more appropriate than others and can be used to forecast malaria cases in both districts.
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Background & objectives: Microscopy is considered as the gold standard for malaria diagnosis, however sub-microscopic infections can only be detected by Polymerase chain reaction, which demands high cost and elaborate laboratory setup. The Micro-chip PCR based Truenat Malaria Pv-Pf and Pf assay is a portable solution for detection of sub-microscopic/asymptomatic cases of malaria in the field, three lots of which were evaluated for P. falciparum and P. vivax malaria. Methods: Three lots of Truenat® Malaria Pv-Pf and Pf assay (kits) were assessed using blood samples of P. vivax and P. falciparum as well as malaria negative blood samples. DNA was extracted from the blood samples using the Trueprep Auto v2 Universal Cartridge based sample prep device and real time qPCR was performed using Truelab DUO micro PCR Analyzer with three lots of Truenat® Malaria Pv-Pf and Pf Assays. Mean, Standard deviation and one-way analysis of variance (ANOVA) was used to assess the significance of inter-lot variability in Cycle threshold values. Results: The Truenat® Malaria Pv-Pf and Pf assays identified the malaria parasites with 100% accuracy. Based on the test for variance (ANOVA) the inter-lot variability in cycle threshold values were not significant, indicating a high degree of precision. Interpretation & conclusion: Based on high accuracy and precision between different lots, the Truenat® Malaria Pv-Pf and Pf assays were found to be suitable for the diagnosis of sub-microscopic infections in field conditions to provide support in elimination of malaria.
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In the current research work, a series of new N-[alkyl/aralkyl]-N-[2,3-dihydro-1,4-benzodioxan-6-yl]-4-chlorobenzenesulfonamides has been synthesized by reacting 1,4-benzozzdioxan-6-amine [1] with 4-chlorobenzenesulfonyl chloride [2] to yield N-[2,3-dihydro-1,4-benzodioxan-6-yl]-4-chlorobenzenesulfonamide [3] which was further reacted with different alkyl/aralkyl halides [4a-n] to afford the target compounds [5a-n]. Structures of the synthesized compounds were confirmed by IR, 1H-NMR, EI-MS spectral techniques and CHN analysis data. The results of enzyme inhibition showed that the molecules, N-2-phenethyl-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4- chlorobenzenesulfonamide [5j] and N-[1-butyl]-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5d], exhibited moderate inhibitory potential against acetylcholinesterase with IC50 values 26.25+/-0.11 ?M and 58.13+/-0.15 ?M respectively, whereas, compounds N-benzyl-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5i] and N-[pentane-2-yl]-N-[2,3-dihydro-1,4-benzodioxin-6-yl]-4-chlorobenzenesulfonamide [5f] showed moderate inhibition against ?-glucosidase enzyme as evident from IC50 values 74.52+/-0.07 and 83.52+/-0.08 µM respectively, relative to standards Eserine having IC50 value of 0.04+/-0.0001 µM for cholinesterases and Acarbose having IC50 value 38.25+/-0.12 µM for ?-glucosidase, respectively
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Drug-drug interactions are most commonly occurring phenomenon in clinical practice. Many physicians are afraid of being involved in an allegation of malpractices due to the occurrence of any severe interaction. These interactions not only occur between drugs but also between any kind of food, tobacco smoke, caffeine and alcohol etc. Therefore, the present study was directed to inspect the effect of caffeine on the anticoagulation activity of warfarin in healthy adult male albino rabbits. Blank blood samples were collected from each rabbit. Rabbits were given warfarin [0.5mg kg-1] orally via stomach tube and blood samples were collected in PT/INR vials at various intervals. After a washout period of 14 days, warfarin was orally administrated at same dose rate along with caffeine [5 mg kg-1 every twelve hours for three days] and same sampling schedule was repeated. Prothrombin time [PT] and the international normalized ratio [INR] of blood samples were determined to estimate changes in the anticoagulation activity of warfarin after its concurrent administration with caffeine. The PT data revealed that Rmax and AUC increased significantly [P=0.05] from 1991.6 and 60.5 to 2124.8 and 67.5, respectively, before and after co-administration. Similarly, a significant [P=0.05] increase was observed in Rmax and AUC of INR from 6.42 and 153.7 to 7.4 and 167.5, respectively, alone and along with caffeine. However, no change was observed in Tmax associated with PT and INR either the drug was administered alone or in combination with caffeine. It was concluded that caffeine has the capacity to inhibit the metabolism of warfarin and enhance its plasma concentration and hence anticoagulant effects. Thus, patients should be advised to limit the frequent use of caffeine-rich products i.e. tea and coffee during warfarin therapy
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Objective: Incidence of Bile Duct Injuries [BDI] during Laparoscopic Cholecystectomy [LC] is reported to be higher as compared to Open Cholecystectomy. Studies have shown varying degree of success in reducing BDI by using Critical View of Safety [CVS] technique before clipping and cutting any structure. In this study, we will see whether CVS technique is faster and safer compared to conventional infundibular technique
Methods: This comparative study was conducted on patients who presented to Surgical Out-Patient-Department [OPD] of Khyber Teaching Hospital from July 2015 to June 2016. Total of 438 patients were divided into two groups. Group-A in which LC was done using infundibular while in Group-B, CVS technique was utilized. Two groups were compared for operating time and BDI
Results: The operative time was significantly reduced for LC using CVS technique [50 mins vs. 73 mins]. Minor leaks were comparable [0.5% vs. 0.9%] but there was a significant difference in major LEAKS between the two techniques [0.5% vs. 1.4%]
Conclusion: Although the "critical view of safety" requires more dissection as compared to infundibular technique, but once learnt and mastered, it is faster and safer identification technique during laparoscopic cholecystectomy
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Objective: To document the clinical presentation of neglected DDH and evaluate the outcome of triple procedure
Methods: It was a descriptive case series study, conducted at the Department of Orthopedic Surgery, National Institute of Rehabilitation Medicine [NIRM], Islamabad over a period of 8-years. It included children aged >1 and <9 years who underwent the triple procedure of open reduction, femoral shortening and Salter's osteotomy. Clinical evaluation was performed using McKay's criteria. Tonnis classification and Severin's scoring system were employed for the radiological evaluation
Results: There were 193 children with 213 DDH affected hips. The mean age was 3.31+/-1.6 years. The preoperative severity of the femoral head dislocation per Tonnis classification was Grade-I in 7.98%[n=17], Grade-II in 48.35%[n=103] and Grade-III in 43.66% [n=93] hips. The postoperative MacKay criteria was 'Good' to 'Excellent' in 193[90.61%] hips. The postoperative Severin's class was I in 113[53%] hips, II in 48[22.53%] hips, III in 43[20.18%] and IV in 9[4.22%] hips. The preoperative acetabular index ranged from 39 degree to 51 degree with a mean of 43.91+/-3.69 degree. The mean postoperative AI was 18.42+/-2.99 degree. The postoperative centre edge angle ranged from 21 degree to 26 degree with a mean 23.18 +/-1.35 degree
Conclusions: The single stage triple procedure offers the surgical remedy of choice with favourable results for managing neglected and late diagnosed DDH among children aged 1-8 years
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The phytochemical screening, antimicrobial, antioxidant and cytotoxic properties of Camellia sinensis were evaluated in the present study. The phytochemical screening revealed the presence of an applicable amount of lycopene, beta-carotenes, flavonoids and tannins in C. sinensis. Among the phytochemicals, tannin was found to be significantly higher in tea plant. The antimicrobial activity of plant extracts against selected bacterial strains namely, Escherichia coli, Staphylococcus aurous, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, Marginella morganii and Haemophilus influenzae was investigated. The results showed that the stem part of C. sinensis presented greater antimicrobial potential than the leaf and root. Antioxidant activity [assessed through % inhibition of linoleic acid per oxidation test] was the highest [89.22%] in n-hexane extract of root part as compared to other extracts. Finally, the cytotoxicity analysis [haemolytic activity against human erythrocytes] of plant extract showed the negligible [%] lysis of RBCs ranging from 1.73 to 4.01%. In conclusion, it can be suggested that C. sinensis is the potential source to obtain bioactive phenolic compounds with high antimicrobial and antioxidant properties, which could possibly be exploited for the treatment of various infectious diseases
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In this study the flavonoids isolated from Artemisia macrocephala were screened out for anticholinesterase activity. The isolated flvanoids were characterized by HNMR, NOESY, COSY, HMBC, HSQC and mass spectroscopy. The compounds [1-4] in appropriate quantities were isolated from chloroform fraction using gravity column chromatography by eluting ethyl acetate/n-hexane solvent system. The flavonoids were characterized and resulted in the form of mono substituted methoxy flavones to tri substituted flavones. Ellman's assay techniques were used to find out enzyme inhibition. Operating environment [MOE] software was used for molecular docking studies. Compounds [1], [2] and [3] showed 88.42+/-2.76, 84.50+/-1.60 and 90.16+/-2.98 percent inhibition of the acetyl cholinesterase [AChE] respectively at 1000µg/mL concentrations with IC50 value 165, 60, 65µg/mL respectively which were comparable to that of standard galanthamine. While for butyryl cholinesterase [BChE], [1], [2] and [3] showed 91.63+/-4.32, 81.03+/-3.53 and 87.69+/-2.84 percent inhibitions respectively at 1mg/mL as compared to the standard galanthamine which caused 96.50+/-2.41 percent inhibition at the same concentration. Whereas, compound [4] exhibited moderate activity for both the enzymes. Molecular docking studies confirmed the experimental AChE and BChE inhibitory activities of the test samples by their virtue of multiple interactions with target enzymes. The results confirm that the specie has biologically active constituents that are more useful for the management of several neurodegenerative ailments like ataxia, Parkinson's disease, Alzeimer's disease and some other types of dementia
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In this work, a new series of 2-[4-[2-furoyl]-1-piperazinyl]-N-aryl/aralkyl acetamides has been synthesized and evaluated for their antibacterial potential. The synthesis was initiated by the reaction of different aryl/aralkyl amines [1a-u] with 2-bromoacetylbromide [2] to obtain N-aryl/aralkyl-2-bromoacetamides [3a-u]. Equimolar quantities of different N-aryl/aralkyl-2-bromoacetamides [3a-u] and 2-furoyl-1-piperazine [4] was allowed to react in acetonitrile and in the presence of K2CO3, to form 2-[4-[2-furoyl]-1-piperazinyl]-N-aryl/aralkyl acetamides [5a-u]. The structural elucidation was done by EI-MS, IR and 1 H-NMR techniques of all the synthesized compounds. All of the synthesized molecules were active against various Gram positive and Gram negative bacterial strains. Among them 5o and 5c showed very excellent MIC values. The cytotoxicity of the molecules was also checked to find their utility as possible therapeutic agents, where 5c [0.51%] and 5g [1.32%] are found to be least toxic in the series
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The present study was conducted to investigate the phytochemical screening and antimicrobial activities of stem bark of Bombax ceiba L. The methanol extract was subjected to qualitative phytochemical screening using standard procedures. The results indicated the presence of alkaloids, tannins, glycosides, reducing sugar, saponins, phlobatanins and terpenoids. The antimicrobial activity was measured by disc diffusion method. Data revealed that Pseudomonas aeruginosa was inhibited by both methanol and ethanol extracts at the concentration of 2mg disc-1 [21.8mm [68.12%] and 21.3mm [66.56%]]. Similarly, methanol extract reduced the growth of Bacillus subtilis by 17.1mm [74.34%] at the concentration of 1 mg disc-1. However, ethanol extract showed a good activity of 18mm [121.6%] and 20.6mm [112.5%] against Xanthomonas maltophilia at concentrations of 1 and 2 mg disc-1, respectively. Aqueous extract showed 16 mm [53.33% Z.I] against Escherichia coli at 2 mg disc-1. Klebsiella pneumoniae was found resistant to all of the three extracts, while the growth of Candida albicans was inhibited by methanol through 16.5 mm [58.92% Z.I] at 1 mg disc-1. The above study concluded the medicinal potential of B. ceiba
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An electrophile, N-[1,3-thiazol-2-yl]-2-bromoacetamide [3], was synthesized by the reaction of 1,3-thiazole-2- amine [1] and 2-bromoethanoyl bromide [2] in an aqueous medium. A series of carboxylic acids, 7a-j, were converted into 1,3,4-oxadiazole heterocyclic core, through a series of three steps. The final compounds, 8a-j, were synthesized by stirring 7a-j and 3 in an aprotic polar solvent. The structural elucidation of the synthesized compounds was supported by IR, EI-MS, 1 H-NMR, and 13C-NMR spectral data. Title compounds were evaluated for enzyme inhibition against cholinesterases and alpha-glucosidase enzymes and their cytotoxic behavior was monitored using brine shrimp assay. The enzyme inhibitor potential of compounds was supported by molecular docking studies
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Objective: To consider the aetiological factors for causing myocardial infarction in younger age group and to include these perspectives for the diagnosis of coronary artery disease. Study Design: A descriptive study. Place and Duration of Study: Study was carried out at CCU in the Department of Medicine, Avicenna Medical College and Hospital Lahore, from Jun 2012 to May 2013
Material and Methods: All patients within the age group of 26-35 years were admitted in CCU on the basis of multiple clinical symptoms by using approach of regular clinical investigations under the aspect of Ischemic heart disease. Clinical investigations were comprised upon cardiac monitoring, lipid profile, ECG and rate for cardiac enzyme included
Results: A total of 18 patients completed the study with age group of 26-35 years. MI was diagnosed in all patients and maximum number of patients with acute MI varied from age 28-33 years. All patients were heavy smokers with high rate of physical stress. On gross clinical examination it was revealed that majority of the patients included in age of 28-33 years was professionally van drivers
Conclusion: The essence of acute MI was observed and critically analyzed in younger age group of people with certain aetiological factors. This should be essentially important in redefining the criterion on clinical grounds for CAD and this should be recognized at International level. As the studies under clinical grounds with the aspect of CAD being reported at International level so, the amount of parameters in clinical diagnosis has to be considered in regular manners for the cure and prevention of CAD in patients especially of younger age groups less than 40
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Objective: The objective of the study is to determine the validity of bispectral in diagnosis of mild and moderate head injury keeping GCS as a gold standard. Study Design: A cross sectional validation study. Place and Duration of Study: This Study was conducted in main Intensive Care Unit of the Combined Military Hospital Rawalpindi and was carried out over eight months from Dec 2009 to Aug 2010
Material and Methods: A minimum of 137 patients were included in study. At the time of admission, Glasgow coma score was calculated by 3 different anesthetists and mean was calculated. At the same time BIS reading was taken using Aspect BIS monitor
Results: Mean age of the patients was 29.5 +/- 6.2. 108 [78.8%] patients were male while 29 [29.2%] patients were female. Mean glasgow coma score was 12.2 +/- 0.9 and mean bispectral index score was 69.9 +/- 8.4. A 2 x 2 table was made between GCS and BIS. Sensitivity was found to be 95.65%, specificity 98.53%, positive predictive value 98.50% and negative predictive value 95.7%. ROC curve was drawn and demonstrated area under curve value of 0.999
Conclusion: BIS monitor can prove to be a useful adjunct in the diagnosis and management of mild and moderate head injury patients in the intensive care units
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Mandibular condylar fracture is one of the most common fractures of mandible. Presence or absence of mandibular third molar is an important risk factor in addition to various other factors. Presence of unerupted mandibular third molar concentrates the stress in angle region leading to its fracture while, in absence of unerupted third molar, forces are diverted towards condyle making it more vulnerable to injury. The objective of this study was to evaluate role of unerupted mandibular third molar in reducing incidence of condylar fracture. A cross sectional descriptive study was conducted at the department of Oral and Maxillofacial surgery, Ayub Medical College, Abbottabad, on 150 patients having condylar fractures over a period of eighteen months. Data on patient's demographics, side of condylar fracture and status of mandibular third molar was obtained and observed. Total number of hemimandibles under study was 175. In 120 patients i.e. 68.6% mandibular third molar was erupted while, in 55 patients i.e. 31.4%, mandibular third molar was unerupted. The results concluded that presence of unerupted mandibular third molar reduces incidence of condylar fracture by 2.2 times so prophylactic removal of these teeth in practice should be discouraged
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N-[Substituted]-5-[1-[4-methoxyphenylsulfonyl]piperidin-4-yl]-4H-1,2,4-triazol-3-ylthio] acetamide were synthesized by following conventional as well as microwave assisted protocol through five consecutive steps under theimpact of various reaction conditions to control the reaction time and the yield of product. Starting from 4- methoxybenzenesulfonyl chloride and ethyl isonipecotate, product 3 was obtained which was converted into product 4by treating with hydrazine hydrate. In step 3, the product 4 was refluxed with methyl isothiocyanate and KOH to yield compound 5 which was finally treated with variety of N-substituted acetamides to yield an array of different new compounds [8a-k]. These synthesized compounds were evaluated for their inhibition potential against bovine carbonic anhydrase [bCA-II], acetylcholinesterase [AChE] and butyrylcholinesterase [BChE] enzymes. Compound 8g demonstrated good activity against bCA-II, AChE and BChE with IC50 values of 8.69 +/- 0.38 MuM, 11.87+/-0.19 MuM and 26.01+/-0.55 MuM respectively. SAR studies assisted with molecular docking were carried out to explore the mode of binding of the compounds against the studied enzymes
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Diabetes is a condition where the fasting blood glucose level elevated above the normal range [80-120mg/dL]. This increase in blood glucose level may be due to the insulin deficiency i.e. insulin dependent diabetes mellitus [IDDM or type I] or due to insulin resistance i.e. non-insulin dependent diabetes mellitus [NIDDM or type II]. Diabetes leads to severe complications in the body even life treating complications e.g. nephropathy, retinopathy, neuropathy increased vascular permeability and delayed wound healing if left untreated. Different drugs are used for the treatment of diabetes mellitus, but synthetic drugs are costly and possess severe side effects. So, more emphasis is being placed on the use of traditional medicines because these sources have fewer side effects than the synthetics drugs and are economical. So the white skinned sweet potato [Ipomoea batatas L.] peel-off was selected for its anti-diabetic effect as well as to see its effects on biochemical parameters. Both young [3-4 months] and old [up to 1 year] Wistar rats were selected for current study. It was found that the aqueous extract of WSSP peel-off had shown beneficial effects. In addition to the decrease in blood glucose level it also decreased protein glycation level total cholesterol, triglycerides, and LDL-cholesterol. Increase in HDL-cholesterol was also observed after treating the rats with aqueous extract of Ipomoea batatas. Additionally, WSSP peel-off had also shown positive results on total protein concentration, albumin, globulin, and plasma enzymes [SGOT and SGPT]. Further research would be needed in order to purify the anti-diabetic components and it should be available in compact dose form for all diabetic patients
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Lovastatin is a natural competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme-A [HMG-CoA] reductase and inhibits specifically rate limiting step in cholesterol biosynthesis. Further, lovastatin in comparison with synthetic drugs has no well-reported side effects. Four pure isolated filamentous fungal strains including Aspergillus niger IBL, Aspergillus terreus FFCBP-1053, Aspergillus flavus PML and Aspergillus nidulans FFCBP-014 have been cultured by solid state fermentation [SSF] using rice straw as substrate for the synthesis of lovastatin. After selecting Aspergillus terreus FFCBP-1053 as the best producer of lovastatin, various selected physical parameters including pH, temperature, inoculums size and moisture content were optimized through response surface methodology [RSM] under center composite design [CCD] for lovastatin hyper production. Maximum lovastatin production of 2070+/-91.5 was predicted by the quadratic model in the medium having moisture content 70% and pH 4.5 at 35 degree C which was verified experimentally to be 2140+/-93.25Mug/g DW of FM [microgram/gram dry weight of fermentation medium], significantly [P<0.05] high as compared to un-optimized conditions while it was noted that lovastatin production is independent on inoculum size [P>0.05] measured by spectrophotometer at 245 nm against standard. It was determined that optimized conditions for the hyper-production of lovastatin from fungal sources have a significant effect
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A number of novel 5-substituted-2-[[6-bromo-3,4-methylenedioxybenzyl]thio]-1,3,4-Oxadiazole derivatives [6a-l] have been synthesized to evaluate their antibacterial activity. Using aryl/aralkyl carboxylic acids [1a-l] as precursors, 5-substituted-1,3,4-Oxadiazol-2-thiols [4a-l] were yielded in good amounts.The derivatives, 4a-l, were subjected to electrophilic substitution reaction on stirring with 6-bromo-3,4-methylenedioxybenzyl chloride [5] in DMFto synthesize the required compounds. All the synthesized molecules were well characterized by IR, [1]H-NMR, [13]C-NMR and EIMS spectral data and evaluated for antibacterial activity against some bacterial strains of Gram-bacteria. The molecule, 6d, demonstrated the best activity among all the synthesized molecules exhibiting weak to moderate inhibition potential